COLUMBUS, Ohio (AP) — State health officials urging Ohioans to ensure they’re vaccinated for measles and mumps say graduation celebrations and summer travel can be opportunities for such diseases to spread if people don’t take preventative measures.

At least 396 cases of mumps have been confirmed in an outbreak of the contagious viral illness in central Ohio.

The total has grown to 164 cases for a separate measles outbreak that began among Amish who had traveled to the Philippines, which has had an epidemic of the respiratory illness. One-hundred of those cases are in Knox County.

The Ohio Department of Health says it has distributed more than 13,000 doses of the measles-mumps-rubella vaccine to fight the measles outbreak. Officials say local health departments have administered more than 8,000 of those doses so far.

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